GPSolo Magazine - October/November 2004

Common Questions for LAPs

By Bonnie Waters, Jeff Fortgang, and Nancy Brown

How can I overcome my lifelong habit of procrastination? What can I do about my partner who is developing a serious drinking problem? How can I breathe new life into my declining practice? How can I get myself organized? Why do I always feel overwhelmed? How can I deal with my overbearing boss? I think I’ve made the wrong career choice—now what? Why does my mood change so dramatically for no apparent reason?

oday’s lawyer assistance program (LAP), unlike its forebears that focused solely on alcohol/drug abuse, may be able to help with a full spectrum of personal and professional dilemmas such as those posed above. The lawyer who can ask these questions has successfully negotiated the first hurdle: admitting a problem. Too often, lawyers, comfortable in the role of trained helper and problem solver, tend to ignore their personal predicaments or attempt do-it-yourself solutions, until small problems become major threats to their careers and well-being.

In addition to the evaluations, referrals, support groups, and other direct services that, in Massachusetts, are provided by our staff of licensed clinicians at Lawyers Concerned for Lawyers, we also reach out to the legal community through a question-and-answer column in our state bar journal. Some questions come directly from lawyers, law students, and judges (including those submitted anonymously via our website), while others are composites based on questions asked by people coming for evaluations. Here are some examples:

I had an anxiety attack in court the other day and was forced to ask for a recess. As in the past, my heart was pounding, my hands were sweating, and I felt as if I was going to die. The problem seems to be worsening, and concealing it from my partners and clients is increasingly difficult. Please advise.

Assuming no underlying medical cause for your symptoms, it sounds as if you are having panic attacks. Panic attacks differ from other anxiety in that the symptoms are largely physical, develop abruptly, and generally peak within ten minutes. Symptoms may also include chest pain, nausea, dizziness, and a fear of dying or “going crazy.” In fact, panic attacks cause neither death nor psychosis, but the experience is very frightening and interferes with functioning. For that reason, we suggest you seek professional help. Both medication and behavioral treatment approaches can be quite effective. If the latter works for you, you may be able to avoid an ongoing dependence on medications (some of which can be addictive). We can assist you in finding the treatment best suited to you, while taking into account your location and insurance.

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Sometimes the source of distress is less psychological and more reflective of circumstances such as stage of life and the larger professional context.

Fifty-five doesn’t seem so old, but somehow my career seems to have left me behind. For years, I saw myself as an effective, conscientious attorney, and my solo practice was successful, with more work coming my way than I could handle. In the last few years, however, my referral sources have dwindled, and work has slowed to one-fourth of what it was. My wife is now the primary earner, while my role and professional identity are eroding. I’m told that I should get out there and market myself, but I just can’t seem to do it. Any suggestions?

We have repeatedly heard concerns similar to yours. As is well recognized, law and other professions have morphed into businesses, creating a “new marketplace.” It can be tough to adapt to these dramatic changes. Competent work is no longer enough—marketing and creativity have become crucial. Although there are no easy answers to this dilemma, it is essential, as well as empowering, to face current realities and move forward with an action plan. Going it alone is difficult and often counter-productive—we have helped attorneys to explore options and develop strategies through networking and career coaching. Sometimes we even help them explore alternative careers.

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Mood disorders have become the most frequent presenting problem we’ve seen in recent years. When lawyers get beyond the wish to avoid acknowledging vulnerability, as well as the inertia often inherent in depression, there is almost always a viable approach that will reduce or remove the burden.

During the past several months I have been constantly exhausted, despite ample sleep. When I found myself becoming short with clients and getting into hostile confrontations with opposing counsel, I decided to talk with my doctor. She put me on Zoloft and said that my symptoms and behavioral changes were signs of depression. I didn’t feel particularly melancholy. Is she right?

Depression has many symptoms, and irritability or moodiness may be among them. Alone, these features do not constitute depression. The diagnosis would require the presence of other symptoms such as sadness, despair, tearfulness, loss of interest in normal activities, change in appetite, change in sleep patterns, or loss of energy/motivation. While many people with depression do feel very sad, others may most readily notice an inability to experience pleasure. It is quite possible to suffer from depression without feeling gloomy. Talking to your doctor is a good first step. We recommend that you also consult with a mental health provider for a thorough assessment and discussion of treatment options. While medication is often an efficacious approach, other strategies include lifestyle changes (e.g., exercise, diet, and relaxation techniques). In addition, various forms of psychotherapy have been shown to exert as powerful an impact on depression as medication, and sometimes the two approaches work best when combined. We can assist in finding the appropriate approach for you.

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Some of the letters and e-mails we receive remind us that those lawyers who have been able to ask for help have benefited from the results. This one brings home the point:

When I made my first appointment with Lawyers Concerned for Lawyers three years ago, it was only under threat of losing my job. With the clarity afforded by hindsight, I now see that my family, my colleagues, and I all would have been better off if I had not delayed getting help; but I was too blind, afraid, and proud. Although I regret the way my past behavior affected my personal and professional relationships, I am also grateful for the help, forgiveness, and encouragement I’ve received from others. If I had a message for other attorneys facing escalating personal problems, it would be to do what I wish I had done: Seek help sooner rather than later.

Bonnie Waters, CEAP, is executive director of Lawyers Concerned for Lawyers, Inc., a private, nonprofit Massachusetts corporation that is the state’s sole lawyer assistance program; she can be reached at bonniew@lclma.org . Jeff Fortgang (Ph.D., CAS) and Nancy Brown (LICSW) are part-time clinicians; they can be reached at email@lclma.org.